FDA Adverse Event Malfunction Summary report: N

AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIVERED

MDR report key: 2863339 · Received December 10, 2012

Report

Report Number
2015691-2012-18788
Event Type
Malfunction
Date Received
December 10, 2012
Date of Event
November 6, 2012
Report Date
November 6, 2012
Manufacturer
EDWARDS LIFESCIENCES
Product Code
NPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT WAS REPORTED IN ERROR. UPON CLARIFICATION WITH THE EDWARDS CLINICAL SPECIALIST, IT WAS CONFIRMED THAT THIS DEVICE WAS NOT DEFECTIVE. THE PATIENT IN THIS CASE HAD A STROKE ONE DAY POST PROCEDURE. THIS WAS REPORTED UNDER MFGR.#. 2015691-2012-18789.

Additional Manufacturer Narrative · 1

INVESTIGATION IS ONGOING.

Description of Event or Problem · 1

AS REPORTED BY THE EDWARDS FIELD CLINICAL SPECIALIST (FCS), DURING THE TRANSAPICAL TRANSCATHETER HEART VALVE (TAVR) PROCEDURE, THE DELIVERY DEVICE WAS NOTED TO BE DEFECTIVE. NO PATIENT IMPACT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIVERED NPT EDWARDS LIFESCIENCES ASCENDRA DELIVERY SYSTEM UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 77 YR